Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 146859 | NY |
NPI | 1013022557 |
---|---|
Provider Name | Mr. Shiv S Bhatt |
First Address | Washington Mills, NY 13479 |
Second Address | Rome, NY 13479 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01418560 | (05) | NY |
711953 | MVP (01) | NY |
C7585 | (02) |